Traumatology and Orthopedics of RussiaTraumatology and Orthopedics of RussiaТравматология и ортопедия России2311-29052542-0933Vreden National Medical Research Center of Traumatology and Orthopedics8810.21823/2311-2905-2014-0-3-142-146ReviewsОбзорыReviewsPATIENTS WITH SUSPECTED METAL IMPLANT ALLERGY: POTENTIAL CLINICAL PICTURES AND ALLERGOLOGICAL DIAGNOSTIC APPROACH (REVIEW)ПАЦИЕНТЫ С ПОДОЗРЕНИЕМ НА АЛЛЕРГИЮ К МЕТАЛЛИЧЕСКИМ ИМПЛАНТАТАМ: ВОЗМОЖНАЯ КЛИНИЧЕСКАЯ КАРТИНА И ДИАГНОСТИЧЕСКИЙ АЛЛЕРГОЛОГИЧЕСКИЙ ПОДХОД (ОБЗОР ЛИТЕРАТУРЫ)ThomasP.ТомасП.
Russian Federation
Peter.Thomas@med.uni-muenchen.deThomsenM.ТомсенМ.
Russian Federation
KrennV.КреннВ.
Russian Federation
SummerB.СуммерБ.
Russian Federation
Ludwig-Maximilians-UniversityМюнхенский университет им. Людвига-МаксимилианаDRK Hospital, Orthopedics and Trauma SurgeryDRK КлиникаCenter for Histology, Cytology and Molecular DiagnosticsЦентр гистологии, цитологии и молекулярной диагностики1210201420314214612092016https://journal.rniito.org/jour/article/view/88

The focus of this review are allergic complications following insertion of metallic orthopedic implants. Such potential allergic reactions encompass eczema, impaired wound and fracture healing, infection-mimicking reactions, effusions, pain and loosening. Nickel, cobalt and chromium seem to be the predominant eliciting allergens. Allergy might be considered prior to planned orthopaedic surgery or in patients with complications following arthroplasty We recommend, that differential diagnoses - in particular infection -should always be excluded in cooperation with surgery collegues. The clinical work up of a patient suspected of suffering from metal implant allergy should include a combined evaluation of medical history, clinical findings, patch testing and histology In vitro testing, namely the lymphocyte transformation test (LTT), can indicate metal sensitization, but needs careful interpretation.

Темой данного обзора являются аллергические осложнения после установки металлических ортопедических имплантатов. Такие потенциальные аллергические реакции включают экзему, замедленное заживление ран и переломов, псевдо-воспалительные реакции, выделения, боли и расшатывание имплантата. Представляется, что самыми сильными аллергенами являются никель, кобальт и хром. Аллергию можно заподозрить до планового ортопедического вмешательства и у пациентов с осложнениями артропластики. Мы рекомендуем совместно с хирургами исключить другие диагнозы, особенно, инфекции. Клинический подход к пациенту с подозрением на аллергию к металлическим имплантатам должен включать всестороннюю оценку анамнеза, клинические данные, кожные пробы и гистологию. Анализ in vitro, в частности реакция бластной трансформации лимфоцитов (РБТЛ), может выявить чувствительность к металлу, хотя и требует тщательной интерпретации.

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